Provider Demographics
NPI:1518122787
Name:MCELWAIN-KELLEY, RITA M (RPH)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:M
Last Name:MCELWAIN-KELLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 STRATTON LN
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:OH
Mailing Address - Zip Code:43977-9712
Mailing Address - Country:US
Mailing Address - Phone:740-310-8203
Mailing Address - Fax:
Practice Address - Street 1:48661 NATIONAL RD W
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9701
Practice Address - Country:US
Practice Address - Phone:740-695-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03119249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist